Cytology - Conventional Pap Test
| WSLH Department: | Cytology |
| WSLH Test Code: | 90000 CP |
| Availability: | Monday-Friday |
| Turn-around Time: | 7 Days |
| Recommended Uses: | Evaluation of cervical-vaginal smear for premalignant, malignant, inflammatory, and infectious changes. |
| Contraindications: | If possible, avoid during the menstrual phase of cycle. Endocervical collection methods not recommended for use on pregnant patients. The test does not sample from the endometrium. Inform patients that there may be some minor painless spotting for a day or two following the Pap test. |
| Additional Tests Performed: |
| Patient Preparations: | Instruct the patient not to douche, use spermicide, or use any vaginal products for 24 hours prior to examination. A warm speculum rinsed in saline solution and containing no lubricant is inserted into the vagina. |
| Specimen Requirements: | Plain glass slides with frosted end. At least the patient's full last name and first initial must be written on the frosted end. |
| Specimen Handling & Transport: | Follow Kit #16 instructions for mailing. Place kit in styrofoam mailer. Tape closed and affix mailing label and postage. Transport via courier or shipping carrier with a tracking option strongly preferred. |
| Collection Kit/Container: |
Conventional Pap Kit #16 and Mailers
|
| Collection Instructions: | Container identification may be affixed with a label or hand-printed and must include: patient's full legal name, DOB, DOS and specimen source. Speculum should be warmed and rinsed in saline solution; no lubricant should be used. Obtain an adequate sampling from the cervix using one of the following methods: SPATULA--Using a plastic spatula, insert the small end of the spatula into the ectocervix. Rotate the spatula one full turn in a clockwise direction. Smear specimen onto one half of slide. BRUSH--Insert a saline-moistened endocervical brush into the os. Slowly rotate the brush in a clockwise direction one-quarter to one-half turn. NOTE that over-rotating the brush may cause excessive bleeding which causes unnecessary patient discomfort and may cause an unsatisfactory Pap test. Roll brush onto other half of slide and immediately spray with fixative or immerse in 95% ethanol. Allow slide to fix in 95% ethanol for at least 15 minutes before allowing to air dry, then place slide in container for transport. CERVEX BRUSH (broom)--Insert the middle bristles of the brush into the endocervical canal. Push gently into of the cervix until the lateral bristles bend against the ectocervix. Maintaining light pressure, rotate the Cervex-Brush four to five times in a clockwise direction. Apply the sample to a microscope slide with a painting action, applying first one side of the bristles and then the other. Immediately apply fixative to the slide. NOTE that material that is allowed to air dry or is not adequately fixed immediately following collection seriously impairs accurate diagnosis. |
| Unacceptable Conditions: | Slides broken beyond repair in transport. Unlabeled glass slides. |
| Requisition Form: |
WSLH Cytology Form 141
|
| Required Information: | Laboratory regulations require the following minimum information to be provided on the requisition form for a specimen to be accepted for testing: Patient name or unique identifier; date and time of collection, patient date of birth and sex, specimen type/site of collection, test request(s), clinician name and UPIN, and address for reporting results. Please be certain that name/identifier on the form matches that on the specimen label. |
| Results Include: | Negative for Intraepithelial Lesions or Malignancy (NILM), Unsatisfactory, Atypical Squamous Cells of Undetermined Significance (ASCUS), Atypical Squamous Cells cannot rule out High Grade Lesion (ASC-H), Atypical Glandular Cells (AGC), Low Grade Squamous Intraepithelial Lesion (LSIL), High Grade Squamous Intraepithelial Lesion (HSIL), Endocervical Adenocarcinoma in situ (AIS), Positive for Squamous Carcinoma, Positive for Endocervical Adenocarcinoma, Positive for Endometrial Adenocarcinoma (ADCA), and Positive for Adenocarcinoma, NOS. Results may also include inflammatory, bacterial, and viral findings. |
| Limitations: | Avoid specimen collection during menses, if possible. Specimens that do not meet basic requirements of cell volumes or are not well-preserved/or visualized may be non-diagnostic and rendered unsatisfactory. Abnormal findings must be correlated with history and other test results. The Pap smear is a valuable screening test for uterine cancer and its precursors. As with any laboratory test, both false negative and false positive results may occur. Positive results should be confirmed with additional studies as clinically indicated. |
| Additional Tests Recommended: | |
| Additional Comments: | In accordance with the latest (2019) ASCCP Management guidelines, additional testing may be recommended in cases atypical, low grade, or high grade diagnosis (web application for the ASCCP Management Guidelines: https://app.asccp.org/). Additional testing may include repeat Pap, HPV, colposcopy, and/or biopsy. Professional Fee for samples forwarded to a doctor may be billed under CPT code 88141 at $21.00 (as of Dec. 2019). |
| Methodology: | Cytologic evaluation of cells collected from the vaginal/cervical area. |
| Includes: | Cervical and vaginal specimens |
| CPT Code: | 88164 |
| Price: | $20.00 |